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Training Faculty (and Others) in Biomedical Informatics. William Hersh, MD Professor and Chair Department of Medical Informatics & Clinical Epidemiology Oregon Health & Science University Portland, OR, USA Email: hersh@ohsu.edu Web: www.billhersh.info
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Training Faculty (and Others) in Biomedical Informatics William Hersh, MD Professor and Chair Department of Medical Informatics & Clinical Epidemiology Oregon Health & Science University Portland, OR, USA Email: hersh@ohsu.edu Web: www.billhersh.info Blog: informaticsprofessor.blogspot.com
Overview of talk Biomedical and health informatics Why we need more faculty What we know about the HIT workforce How we can/should build the HIT workforce The HITECH workforce development program
Biomedical and health informatics (BMHI) • “The field that is concerned with the optimal use of information, often aided by the use of technology, to improve individual health, healthcare, public health, and biomedical research” (Hersh, 2009) • It is more about information than technology • We pay inadequate attention to • The growing deluge of data and information (Stead, 2010) • The role of information in medical education and subsequent practice (Shortliffe, 2010) • The critical role and importance of people, including academics, practitioners, and users (Hersh, 2010)
Why do we need more BMHI? • In healthcare • Quality – not as good as it could be (McGlynn, 2003; Schoen, 2009; NCQA, 2010) • Safety – IOM “errors report” found up to 98,000 deaths per year (Kohn, 2000); problem persists (Classen, 2011) • Cost – rising costs not sustainable; US spends more but gets less (Angrisano, 2007) • Inaccessible information – missing information frequent in primary care (Smith, 2005) • In other areas • Clinical and translational research (Bernstam, 2009) enabling the learning healthcare system (Friedman, 2010) • Enabling patients, consumers, etc. (Gibbons, 2009)
Why do we need more faculty (and others)? • Growing use of BMHI as users • Improving healthcare quality, safety, cost-effectiveness, etc. • Meeting meaningful use and other incentives • Communicating with and empower patients • Enabling research, public health, etc. • Increasing career opportunities as • Academics/researchers – research, teaching, and leadership • Professionals/practitioners – new subspecialty and other opportunities
How do we train more faculty (and others)? • Historically most BMHI education at graduate level • Informatics is inherently interdisciplinary and there is no single job description or career pathway • More information on programs on AMIA web site • http://www.amia.org/informatics-academic-training-programs • Commentary at • http://informaticsprofessor.blogspot.com • Let’s look at • Competencies • Funding opportunities • OHSU experience
What competencies should informaticians have? (Hersh, 2009) • Health and biological sciences: • Medicine, nursing, etc. • Public health • Biology Competencies required in Biomedical and Health Informatics • Management and social sciences: • Business administration • Human resources • Organizational behavior • Computational and mathematical sciences: • Computer science • Information technology • Statistics
Inventory of competencies for various groups (Hersh, 2010) … • Competencies differ by group • Informaticians • Developing, implementing, and evaluating systems • Making optimal use of information • Clinicians • Applying informatics in delivery of care • Patients • Health information literacy
Funding for BMHI training • Mostly self-funded, sometimes at institutional level • e.g., University of Connecticut HSC “grow your own” • Research training historically available through NLM (NIH) training grant program • http://www.nlm.nih.gov/ep/GrantTrainInstitute.html • New opportunities in ONC Workforce Development Program funded under HITECH Act • http://healthit.hhs.gov/portal/server.pt/community/ healthit_hhs_gov__workforce_development_program/3659
ONC Workforce Development Program Based on need for 51,000 professionals in 12 workforce roles • Five universities funded to develop curricula for community college programs • OHSU funded to develop curricula and to serve as National Training & Dissemination Center (NTDC) • Nine universities funded, with emphasis on short-term training using distance learning • OHSU funded to enroll trainees in existing programs
Experience of the OHSU program • http://www.ohsu.edu/informatics • Graduate-level programs at Certificate, Master’s, and PhD levels • “Building block” approach allows courses to be carried forward to higher levels • Train practitioners and researchers from a wide variety of backgrounds • Mostly self-funded but some funded by NLM, ONC, and others • Two “populations” of students • “First-career” students more likely to be full-time, on-campus, and from variety of backgrounds • “Career-changing” students likely to be part-time, distance, more likely (though not exclusively) from healthcare professions • Many of latter group prefer “a la carte” learning • This has led to the successful 10x10 (“ten by ten”) program that started as OHSU-AMIA partnership (Hersh, 2007; Feldman, 2008)
Overview of OHSU graduate programs PhD - Knowledge Base - Advanced Research Methods - Biostatistics - Cognate - Advanced Topics - Doctoral Symposium - Mentored Teaching - Dissertation Masters - Tracks: - Clinical Informatics - Bioinformatics - Thesis or Capstone Graduate Certificate - Tracks: - Clinical Informatics - Health Information Management 10x10 - Or introductory course
Challenges • Institutions do not understand informatics • Do not fully appreciate potential synergy with research, clinical enterprise, and/or education • Growing departmental “self-sufficiency” models that discourage collaboration and encourage silos and short-term thinking • Exacerbated by tightening of NIH, state, and other budgets • Informatics departments do not fit in classical basic-clinical divide
For more information • Bill Hersh • http://www.billhersh.info • Informatics Professor blog • http://informaticsprofessor.blogspot.com • OHSU Department of Medical Informatics & Clinical Epidemiology (DMICE) • http://www.ohsu.edu/informatics • http://www.youtube.com/watch?v=T-74duDDvwU • http://www.informatics-scholarship.info • http://oninformatics.com • What is Biomedical and Health Informatics? • http://www.billhersh.info/whatis • Office of the National Coordinator for Health IT (ONC) • http://healthit.hhs.gov • American Medical Informatics Association (AMIA) • http://www.amia.org • National Library of Medicine (NLM) • http://www.nlm.nih.gov